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November 16, 2017

Playing It Safe: How to avoid musicians RSI

I’m as guilty as the next musician for not warming up before a gig. I’d repeatedly arrive at venues, jump on stage and play an hour set only to find my fingers aching in the break. I’ve worked with countless musicians and noticed just like me, many of them do the same and even worse, don’t warm up before lengthy practice sessions. In this article I hope to highlight the potential problems failing to warm up before playing an instrument can have, as well as how warming up can improve the quality and accuracy of your playing during practice sessions as well as on stage.
Just like sportspeople and athletes put in hours of training, musicians also spend hours practicing. This requires the type of physical endurance that often leads to strain on certain parts of the body, and for the musician this is typically the hands. 

Really, musicians should put the same importance into warming up and stretching as athletes to help avoid common issues such as Repetitive Strain Injury (RSI). RSI is a general term used to describe the pain felt in muscles, nerves, and tendons caused by repetitive movement and overuse and in extreme cases, RSI can end a musicians career. I met a fellow musician who had to completely stop playing the violin due to a bad Repetitive strain injury, saying it had become increasingly painful to play her instrument and her Doctor advised her to stop playing for at least a year. This is the worst case scenario and every musician’s worst nightmare.

How do we know if we have RSI? 

The symptoms of RSI according to the NHS can range from mild to severe and usually develop gradually. They often include pain, aching or tenderness, stiffness, throbbing, tingling or numbness, weakness and cramp.

Doctor Jonathan Kuttner, a doctor that specializes in musician related injuries, says ‘There are five stages to measure severity!’

Grade I:
Pain occurs at the site of overuse only. Pain is mild and disappears after practicing or performing is finished. Adequate rest periods between, heat therapy, stretching, and massages may be effective.

Grade II:
Pain at multiple sites, pain is more severe. No interference with normal daily activities. Icing, rest, massage, anti-inflammatories, appropriate compensatory stretching, and relaxation skills may alleviate symptoms.

Grade III:
Pain exists at multiple sites, pain persists after playing. Some pain accompanying daily activities. May have loss of facility, some weakness in immediate and associated areas.

Grade IV:
Same as Grade III but all Activities of Daily Life are accompanied by pain, and there is impairment of functioning.

Grade V:
Loss of capacity to use affected area is secondary to disabling pain. The injured individual cannot use that part of the body when making music or for any other activity.

So how can we prevent the above and improve our playing? 

In order to prevent injury, we need to know what the common causes are! Doctor Kuttner says if we are aware of the common causes, we can understand what we did to cause the discomfort and avoid making the same mistake which may lead to severe injury if not dealt with. Below is Doctor Kuttner’s list, which he advises musicians to think of whenever they feel discomfort or pain while playing.

Common Causes of RSI

• Not warming up properly
• Increasing length and intensity of playing
• Error to technique
• Using unnecessary force on the instrument
• Bad posture
• The wrong instrument setup

So in order to prevent injury and improve our playing, we must remember the following before and while we are playing our instrument.

• Stretch before playing
• Start with something simple like scales before challenging pieces
• Review and be aware of your technique and posture
• Relax while playing and don’t use unnecessary force and energy
• Take regular short breaks
• Drink lots of water and eat well
• Take note of any discomfort and resolve the problem

If you do find you are experiencing discomfort or even pain while playing we highly recommend speaking with a professional as soon as possible.

Some statistics

• A concert pianist can on average hit 45,000 notes during an hour performance.
• Christine Zazza’s meta-analysis discovered 49-85% of musicians have significant injuries during their career.
• The most common area for pain with musicians is in the hand & wrist


• The Athletic Musician: A Guide to Playing Without Pain

Doctor Kuttner



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